Drug
Sensitivity Testing
Microculture
kinetic (MiCK) assay is used to identify
chemotherapeutic agents that are the most
effective in inducing apoptosis in tumor
cells isolated from a specific patient.
The MiCK assay is performed in a 96-well
plate and allows testing sensitivity of
the tumor cells to both single drugs and
drug combinations. The referring physician
may request testing sensitivity of the patient's
tumor cells to specific chemotherapeutic
agents or DiaTech may offer different panels
of agents based on the patient's diagnosis
and clinical history. Depending on the type
of the specimen, testing results are available
within 26 to 28 hours (leukemia/lymphoma)
or 36-72 hours (solid tumors) after the
specimen is received in the DiaTech laboratory.
Diagnostic
multiparameter flow cytometry immunophenotyping
can be performed on the specimen submitted
for chemosensitivity studies if desired.
DiaTech Oncology also offers flow cytometry
immunophenotyping as an independent service.
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Leukemia
and Lymphoma
The
MiCK assay can be used to determine drug
sensitivity of blasts isolated from patients
with acute
leukemias (AML and ALL), or blast phase
of chronic myeloid leukemia (Kravtsov et
al., 2000), and neoplastic cells of lymphoma
patients. We also have experience in
testing drug sensitivity of blasts isolated
from patients with high-grade myelodysplastic
syndrome (not published). It has been shown
that acute myeloid leukemia patients whose
treatment protocols included agents to which
the patient's tumor cells were sensitive
in the MiCK assay had increased rate of
the complete remission (CR) and a significant
advantage in long-term survival [Kravtsov
et al., 1998; Kravtsov et al., 2001). In
a limited study, the MiCK assay was successfully
used to direct chemotherapy of patients
with AML and blast phase of CML [Kravtsov
et al., 2000]. Although there were no similar
studies performed for lymphoma patients,
the MiCK assay was demonstrated to detect
drug-induced apoptosis in primary cultures
of neoplastic cells from lymphoma
patients. Using the MiCK assay, we may
identify chemotherapeutic agents which are
most effective in inducing apoptosis in
lymphoma cells and, therefore, have the
greatest probability to reduce tumor burden
if included in the patient's treatment protocol.
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Solid
Tumor
For
research purposes, the MiCK assay was successfully
used with cell lines originating from different
types of solid tumors including colorectal
carcinoma , bladder
carcinoma, neuroblastoma,As
part of the clinical services, drug sensitivity
profiles were studied for tumor cells isolated
from patients with advanced stages of breast,
colon, lung, ovarian, prostate, and gastric
carcinoma, visceral melanoma, soft tissue
sarcoma, and carcinoma of unknown primary.
Clinical trials to establish correlations
between the MiCK assay results and treatment
outcomes in patients with solid tumors are
under way. For more information on the clinical
trials, please go to http://www.clinicaltrials.gov/ct/show/NCT00243685
At present, DiaTech may identify chemotherapeutic
agents which are the most effective in inducing
apoptosis in tumor cells of a specific patient
and, therefore, have the greatest probability
to reduce tumor burden if included in the
patient's treatment protocol. top
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Diagnostic
Multiparameter Flow Cytometry Analysis
DiaTech
Oncology offers diagnostic multiparameter
flow cytometry immunophenotyping service,
which can be ordered on the specimens submitted
for chemosensitivity testing or as an independent
study. Four- or five-color flow cytometry
immunophenotyping with comprehensive panels
of antibodies is used to:
-
Make a diagnosis and assign cell lineage
to leukemia and lymphoma
- Detect
a minimal residual involvement by leukemia
and lymphoma after therapy
- Diagnose
and monitor progression of stem cell disorders
including myelodysplastic syndrome and
paroxysmal nocturnal hematuria (PNH)
- Enumerate
CD34-positive cells
- Perform
DNA analysis of cells from viable and
archived tissues
- In
some cases of non-hematopoietic malignancies,
flow cytometry immunophenotyping is useful
in detecting an expanded population of
epithelial cells and, therefore, may serve
as an accessory tool to morphologic studies.
Click here to see examples of flow cytometry study reports
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Morphologic
bone marrow evaluation is performed
on H&E-stained tissue sections and/or
Wright-Giemsa stained bone marrow aspirate
smears and/or touch preparations. Special
stains including PAS, MPO, NSE, TRAP, GMS
and others are used when clinically indicated
upon verbal approval from the referring
physician. Morphologic bone marrow evaluation
can be ordered on the specimens submitted
for chemosensitivity testing or as an independent
study. If a malignancy is diagnosed, we
inform the referring physician immediately
by phone and generate a written report within
24h.
Peripheral
blood smears are routinely examined
with Wright-Giemsa stain. Special stains
are added when clinically indicated upon
verbal approval from the referring physician.
Morphologic peripheral blood evaluation
can be ordered on the specimens submitted
for chemosensitivity testing or as an independent
study. If a malignancy is diagnosed, we
inform the referring physician immediately
by phone and generate a written report within
24h.
CSF
and other body fluids examination is
performed on the Wright-Giemsa-stained cytospin
preparations. A cytocentrifuge is utilized
to concentrate cells from the body fluids
to make morphologic evaluation more efficient.
.
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Cytogenetics
and Molecular Studies
Classic
cytogenetic and FISH studies are utilized
to reveal chromosomal abnormalities. Most
common chromosomal abnormalities associated
with myeloproliferative and lymphoprolyferative
disorders include t(9;22) seen in CML, t(15;17)
seen in promyelocytic leukemia, t(14;18)
seen in follicular lymphoma, t(11;14) seen
in mantle cell lymphoma, t(2;5) seen in
anaplastic large cell lymphoma. Molecular
diagnostic studies for B- and T-cell clonality,
and BCR/ABL, BCL-1, and BCL-2 translocation
analyses are also available upon request.
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